TY - JOUR
T1 - Antimicrobial Resistance, Politics, and Practice in India
AU - Broom, Alex
AU - Doron, Assa
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - India is considered the epicenter of the global antimicrobial resistance crisis, with unprecedented antimicrobial consumption, production, and “misuse.” But the story of resistance in India is complicated—emerging from intersections of industrial pharmaceutical development, rationing/purchasing of health care, policy infrastructure, and dynamics of disadvantage. What looks like rampant, escalating antimicrobial misuse and a need for tighter controls over drugs and “prescribers,” emerges as a complex social problem. These dimensions reach the bedside, although variously, with doctors in India dealing with precarious infectious disease landscapes, threats of multidrug-resistant organisms, and (pan) national imperatives for “more judicious” practices. Drawing on 24 semi-structured interviews with doctors in Hyderabad, we explore their perspectives on resistance (literal and figurative) in everyday practice, and how practices articulate intersections of power, influence, and governance. This offers broader context to reframe resistance in India as multifactorial, enacted through cultural/local practices, and irreducible to singular problems of control or regulation.
AB - India is considered the epicenter of the global antimicrobial resistance crisis, with unprecedented antimicrobial consumption, production, and “misuse.” But the story of resistance in India is complicated—emerging from intersections of industrial pharmaceutical development, rationing/purchasing of health care, policy infrastructure, and dynamics of disadvantage. What looks like rampant, escalating antimicrobial misuse and a need for tighter controls over drugs and “prescribers,” emerges as a complex social problem. These dimensions reach the bedside, although variously, with doctors in India dealing with precarious infectious disease landscapes, threats of multidrug-resistant organisms, and (pan) national imperatives for “more judicious” practices. Drawing on 24 semi-structured interviews with doctors in Hyderabad, we explore their perspectives on resistance (literal and figurative) in everyday practice, and how practices articulate intersections of power, influence, and governance. This offers broader context to reframe resistance in India as multifactorial, enacted through cultural/local practices, and irreducible to singular problems of control or regulation.
KW - AMR
KW - Asia
KW - antimicrobial resistance
KW - health care professionals
KW - pharmaceuticals
KW - qualitative
KW - self-care
KW - semi-structured interviews
UR - http://www.scopus.com/inward/record.url?scp=85085498794&partnerID=8YFLogxK
U2 - 10.1177/1049732320919088
DO - 10.1177/1049732320919088
M3 - Article
SN - 1049-7323
VL - 30
SP - 1684
EP - 1696
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 11
ER -